Individual
DR. ELISABETH BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2330 NW FLANDERS ST STE 107, PORTLAND, OR 97210-3400
(917) 727-0825
Mailing address
2330 NW FLANDERS ST STE 107, PORTLAND, OR 97210-3400
(917) 727-0825
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
021321
NY
103TC0700X
Clinical Psychologist
Primary
3072
OR
103TC0700X
Clinical Psychologist
61425975
WA
Other
Enumeration date
07/03/2013
Last updated
04/22/2024
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